Organization
KG HOLLYWOOD SMILE DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTINA GABRILYANTS (PRESIDENT)
(718) 299-5900
Entity
Organization
Contact information
Practice address
2 DIAMOND STREET, BROOKLYN, NY 11222
(718) 299-5900
(947) 271-3011
Mailing address
2 DIAMOND STREET, BROOKLYN, NY 11222-2508
(718) 299-5900
(947) 271-3011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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